Eco­nomic coun­cil says Trump is not sab­o­tag­ing Oba­macare

Half­way through his four-year term, Pres­i­dent Trump hasn’t able to de­liver on a cam­paign prom­ise to get rid of Oba­macare. In­stead, the ad­min­is­tra­tion said Fri­day, the White House has found a way to make it work for ev­ery­one.

The White House Coun­cil of Eco­nomic Ad­vis­ers re­ported last week that three of Mr. Trump’s big­gest changes to the law — changes Democrats call “sab­o­tage” — will re­sult in $450 bil­lion in net eco­nomic ben­e­fits over the next 10 years.

The ben­e­fits flow to con­sumers, who will find cheaper op­tions and won’t be fined for shirk­ing in­sur­ance they don’t want, and to tax­pay­ers, who won’t have to sub­si­dize people who never wanted Oba­macare plans in the first place, ac­cord­ing to the coun­cil’s anal­y­sis.

The changes will also slash ad­min­is­tra­tive costs tied to the Af­ford­able Care Act’s reg­u­la­tions, the coun­cil said.

The coun­cil, which ad­vises the pres­i­dent, ac­knowl­edged trade­offs in Mr. Trump’s push to gut Oba­macare’s penalty for shirk­ing in­sur­ance and ex­pand the reach of cheaper, skimpier al­ter­na­tives to the law’s of­fer­ings.

Some higher earn­ers, who don’t qual­ify for tax­payer-funded sub­si­dies un­der Oba­macare, will face higher pre­mi­ums, as healthy people opt out of the ex­changes and into Mr. Trump’s work­arounds, the re­port said.

The coun­cil said that’s a small price to pay for eas­ing the pain for mil­lions of people who un­der the old sys­tem had been sub­si­diz­ing the costs of sicker cus­tomers.

“The ben­e­fits of giv­ing some con­sumers more in­sur­ance cov­er­age op­tions out­weigh the costs im­posed on those con­sumers who are pro­jected to pay higher pre­mi­ums,” the re­port said.

It’s a shift from the early days of the Trump White House when it said the health law was on the brink of col­lapse and that a GOP-con­trolled Con­gress would sweep in with a bet­ter plan. Repub­li­can ef­forts failed, forc­ing Mr. Trump to fig­ure out what he could do on his own.

He let con­sumers hold onto “short­term” plans, which don’t have to com­ply with pro­tec­tions for sicker Amer­i­cans, for a full year. The move re­stored an Obama-era stan­dard that lasted un­til 2016, when the last pres­i­dent short­ened their max­i­mum du­ra­tion to three months.

And Mr. Trump ex­panded the reach of as­so­ci­a­tion health plans that let people in like-minded trades band to­gether to im­prove their pur­chas­ing power. The plans don’t have to cover the com­plete menu of ben­e­fits de­manded by Oba­macare.

Mr. Trump boasts most fre­quently about his push to zero out Oba­macare’s “in­di­vid­ual man­date” penalty in the GOP tax over­haul. Repub­li­cans said it tended to pun­ish fam­i­lies mak­ing less than $50,000 and wasn’t very ef­fec­tive in prod­ding healthy people into the pro­gram.

“The penalty and other re­stric­tions on con­sumer choice are not needed to sup­port the guar­an­teed is­sue of com­mu­ni­tyrated health in­sur­ance to all con­sumers, in­clud­ing those with pre­ex­ist­ing con­di­tions,” the re­port said. “The ACA premium sub­si­dies sta­bi­lize the ex­changes.”

That ar­gu­ment is at odds with a stat­edriven law­suit that seeks to in­val­i­date Oba­macare. GOP state at­tor­neys gen­eral say be­cause the man­date and the law’s good­ies were sup­posed to in tan­dem, the law is no longer con­sti­tu­tional.

The Trump ad­min­is­tra­tion has taken a hands-off ap­proach to the law­suit, en­rag­ing Democrats who say the Jus­tice Depart­ment has an obli­ga­tion to de­fend fed­eral law.

Oba­macare’s de­fend­ers re­jected the coun­cil’s find­ings Fri­day, say­ing it at­tempted to pa­per over Mr. Trump’s dam­age to the pro­gram af­ter Democrats re­took the House by run­ning on health care.

“The Trump ad­min­is­tra­tion’s re­lent­less sab­o­tage of our health care sys­tem is well-doc­u­mented,” said Brad Wood­house, ex­ec­u­tive di­rec­tor for Pro­tect Our Care. “In Novem­ber, vot­ers took to the polls and re­jected the Repub­li­can war on health care, and the fact that this ad­min­is­tra­tion is launch­ing a mas­sive cover-up of their sab­o­tage means that they’re al­ready brac­ing them­selves against the wrath of vot­ers in 2020.”

The White House coun­cil said it sim­ply took a more holis­tic ap­proach than past stud­ies, which fo­cused on sign-ups in Pres­i­dent Obama’s pro­gram in­stead of its im­pact on all pop­u­la­tions.